Interview answers about Rec Therapy and mental health

A student asked me 19 questions about recreation, recreation therapy, and mental health.

I posted my answers below so more people could read them.


Questions for Issue Paper: Interviews


  1. What is your current occupation?


(I provide a mix of mental health counseling and recreational therapy services)


  1. Describe your place of work.

Psychiatric Residential Treatment Facility (PRTF). I provide services for three residential units for children and adolescents with various mental/ behavioral health needs.

These three residential treatment programs are housed/ located in a psychiatric hospital.


  1. What is the general age group of the people under your care?

Typically 7 to 17.

Sometimes, bur rare 6 or 18.


  1. Do you typically work with individuals who suffer from mental health issues?



  1. What kinds of mental health issues do you see as being more common today?

I’ve heard from a speaker (can’t recall name) that there is a growing number of adolescents with anger issues in our country (United States). I put U.S. because I wasn’t sure if you’re in U.S. or Canada.

Substance abuse issues seem pretty baseline (based on own personal experiences)


  1. What role (if any) do you see yourself playing with respect to treating people/patients suffering from mental health issues?

My role consists of:

  • Providing a humanistic approach that consists of: unconditional positive regard, empathetic listening, and validation.
  • I provide a mix of assessments.
  • I work with patient to create a treatment plan to address her (or his) needs as well as address and promote strengths
  • I provide a mix of treatment interventions (individual sessions, group sessions, sometimes family sessions) to assist the patient with meeting goals
  • I write progress evaluations of goals that were met.


  1. Are there any types of programs set up in your workplace to help people who suffer from mental health challenges?

We have three different residential treatment programs, including:

The Bridge Program for children (7 to 12) with abuse-reactive needs. This is my main focus area. I have additional training and experience with this population.


We have two other residential programs. I assist their units by providing group interventions/ skills training sessions:



The Road Program for adolescents male and female with dual diagnosis (substance abuse and mental health needs

The Roundtable Program for adolescent males with sex offender needs


  1. If so, are those programs experiencing success?
  • Trauma-focused Cognitive Behavior Therapy (TF-CBT) is the main intervention for the children with abuse-reactive needs. There is a lot of research evidence that shows TF-CBT is an effective treatment (for most children). This is the program that I primarily provide services for.


  • Our therapist for the substance-abuse unit (dual dx) has a lot of experience working with that population. They also have a 12-steps program (is not a treatment) and there is no research on it for evidenced-based outcomes, but it appears to be helpful.
  • There is no cure for the adolescents with sex offending behaviors. The therapist go to intensive training. Outcomes for those adolescent who receive treatment are not 100%, but they are less likely to offend compared to those who don’t receive treatment.


I can connect you to those people who have additional training and experience with those two areas (substance-abuse) or (sex offending) if you’d like to have access to more information.



  1. Are there programs in other areas of the community (other than where you work) that focus on recreational activities to target individuals suffering from mental health issues?

We do have one outpatient recreation therapy program that uses horse-therapy.

One of my friends also offers online services at:

There are several outpatient and community-based recreational therapy programs across the United States.


  1. Given that mental health constitutes an important component of health care, do you feel it receives as much support as other areas of health care? Why? Why not?

I feel it gets a lot of support because there are a wide-range of professionals who work in mental health, including: psychiatrists, psychologists, social workers, mental health counselors, clinical case managers, and recreational therapists. We’re not alone in promote mental health.


  1. What do you think would be the biggest challenge in using recreation programs to help patients with mental health issues?

Possibly advocating the importance of it. I do think having a good education component (Leisure Education) or sometimes (Psycho-Education) or sometimes life skills training is good to teach the importance of recreation with mental health and overall health and well-being.


  1. Are there any interventions that you are aware of that focus on recreation programs?

We use recreation as a treatment at our facility.

It isn’t so much about the recreation activity.

The focus is more on the outcomes.

In example- two different recreation activities could help a patient to achieve the outcome.


  1. What do you think would be the biggest challenge in using recreation programs to help patients with mental health issues?

Based on personal experience: safety concerns. Close supervision is required. A patient with mental health needs could steal recreation supplies to use for self-harm at a later point, or attempt to run-away on a community outing. There are so many more possibilities too.


  1. Do you think that physical activity could help people that suffer from a mental health problem? Please explain.

There is a lot of research that shows physical activity helps with promoting mental health benefits as well.

Psychiatrics often suggest physical activity and exercise help mood-stabilizers and other medicines to work.


  1. Do you have any knowledge of recreation therapy being used to help psychiatric patients?

Yes – we use recreation therapy at our psychiatric hospital.

The greatest number of Certified Therapeutic Recreation Specialists (CTRS) work in mental/ behavioral health settings. Contact the National Council for Therapeutic Recreation Certification (NCTRC) for more information.


  1. How do you think the use of recreational therapy has evolved over the years?

It has evolved along with technology. I’ve worked in the field for 15-years.

There are Wii video games that help promote physical health and wellness.

The internet allows for patients to build a support system through sites like facebook.

There are good apps like fitbit that keeps track of how much a person has walked and calories burned.

One thing that has stayed consistent in our field is the APIE process of assessments, program/ treatment planning, implementing the activity-based/ recreation as an intervention, and evaluation the outcomes.


  1. Do you think there has been a shift in society’s attitudes/perception of people with mental illness? Explain.

One of the shifts is “people-first language.” Based on my experiences, I’ve heard people identified by their disorder, in example, “Here comes a borderline” for a person who has a diagnosis of borderline personality disorder. Would you say: “here comes a cancer? For a person who has cancer?” People first language example: Meet Sue. She is a person. She happens to have xyz.”

I do think there is less stigma. Years ago, in the U.S. there was a politician who wanted to be President and he was considered “un-electable” because he had talked to a counselor or psychologist. Of course, today, there are more rules about confidentiality and privacy. Overall, I think there is less stigma and concern about a person who talks to a mental health professional.


  1. How do you see the role of physical activity evolving over the next few years with respect to its use in the area of mental illness?

I’d recommend looking into information from WHO, The World Health Organization. They appear to have a greater focus on prevention of illness. I personally believe that we, recreational therapists have a great opportunity to intervene and be the leaders in preventative medicine.


  1. Could you comment on why there seems to be more young people today suffering from mental health issues?

There could be a lot of reasons. Some of them:

  1. Child suffered from abuse or neglect at an early age
  2. Child exposed to drugs/ substance abuse at an early age
  3. Increase in digital technology could be a concern if the child is spending too much time online and not enough time with real friends. Or if the child is being exposed to material online (violence, porn) or if parents are too busy on electronics and ignore child.

Those are just my ideas.



Let Kids Be Kids: Using Adventure and Nature to Bring Back Children’s Play

Blog written by guest-blogger: CAILEIGH FLANNIGAN

Caileigh is a play practitioner who uses forms of play as a way to promote children’s development and emotional healing. She is an outdoor play and loose parts researcher who is spreading the word about the importance of free play in natural environments.

Note: This article was originally published at


 It is a disappointing thing to see new playgrounds developed in city spaces sit there empty each day, or to walk in the park and hear no laughter. What is missing here is not the children per se, but materials and environments that create challenge, imagination, and creativity that make children want to play outdoors. The absence of such play environments is not only influencing the quantity and quality of children’s play, but also affecting children’s health and well-being. As adults, we need to support children in learning to enjoy what free play in the outdoors has to offer. We need to inspire imaginations, creative minds, and capable bodies. To do this, we can look toward two simple things: nature and adventure.

What’s Happening to Children’s Play?

Outdoor play is a necessary part of children’s development and is considered essential for children’s play and learning. Playing outdoors provides unique opportunities for learning that the indoor environment cannot offer. For example, children engage in higher levels of creativity, imagination, inventiveness, physical activity, language, and curiosity. Most importantly, they are given the opportunity to play freely. Despite this knowledge, outdoor play has been steadily decreasing for North American children.

When we look at why this disappearance of free play is happening, we realize that there are many factors that contribute to the lack of play. There are increases in structured play activities, an emergence of technology-based play objects, higher concerns related to safety and risk, adult control over children’s play activities, academically oriented schools, and an overall disregard for the value of play. More often than not, we see children engaged in a summer filled with structured sports activities or stuck inside with gaming systems and cell phones. We hear adults saying “don’t pick up the sticks!” “don’t go too far!” and “be careful!”. We know that schools are decreasing recess time or taking it away all together.

Unfortunately, it is all too common that today’s society has an overall disregard for the value of play and how important it is for children of all ages. It is ultimately these factors that are placing a barrier between children and their right to play freely in the outdoors.

The inability to cross over this barrier is affecting children in many areas of development. For example, there are increases in anxiety and depression at younger ages as well as difficulties with emotional regulation and self-control. Increases in physical conditions such as diabetes, obesity, and asthma are becoming more apparent in young children and childhood disorders such as attention deficit hyperactivity disorder and obsessive-compulsive disorder are more frequently diagnosed. Children who do not have access to outdoor play will miss out on the many benefits that free play in the natural environment has to offer toward their growth.

Illustration 1 code:

Why The Decrease in Free Play - Bring Back Children’s Play
Source: Blog

The Importance of Free Play in the Outdoors

When children are engaged in free play in the outdoors, they are provided opportunities for freedom, choice, and fewer routines. In free play, there is no adult direction or control, so children are able to play how they want to play. When children are given such freedom to play, they are more likely to engage in higher levels of social interaction, cognitive skills such as decision-making and reasoning, empathy, and physical activity. In turn, they are less likely to become inattentive, anxious, or depressed and unhealthy.

Illustration 2 code:

The Benefits of Outdoor Free Play - Bring Back Children’s Play
Source: Blog

The outdoor environment in particular has many benefits. A natural green space allows children to continuously explore ways to use materials, discover the varied environment, and create their own play experiences. The outdoor environment is not a man-made area and, therefore, is diverse and timeless. Children who play outdoors have heightened senses and emotions from the ever-changing topography and the rich stimuli that a natural space affords. This is how children learn – through experience: by seeing, feeling, touching, and hearing. The outdoor environment is a blank canvas on which children are able to place their own thoughts, wonders, and creations.

The Loose Parts Movement for Bringing Back Play

So what can be done now? After this discussion of the importance of free play in the outdoors you may be wondering how you can bring back play for children in your life. There are two things to support you in doing so: nature and adventure. What you are going to need to do is reintroduce adventure back into children’s outdoor play. To accomplish this, you can use loose parts.

Loose parts are play objects and materials that are open-ended, manipulative, moveable, and non-dictated. This means that children can use the materials in a variety of ways and there is no suggested way or “story” behind these materials. Loose parts allow children to act upon their environment the way that they want, rather than their imaginations and creativity being predetermined by the materials.

Examples of loose parts are items such as tires, logs, sticks, fabric, rope, and rocks. Loose parts can either be synthetic materials or materials that are commonly found in a natural outdoor environment. Loose parts spark children’s curiosity, which then leads to exploration and discovery. For example, if a child is provided with rope, tarp, and wooden pieces, she will become curious about what the materials are and how to use them. She will then begin to explore the materials in different ways through her imagination and creativity. This leads to discovering that the materials can do many things. This process of curiosity, exploration, and discovery is ultimately what leads to play and learning.

Where Can I Find Loose Parts?

You can find loose parts in many places, and they are often free!

  • Parks, forests, and natural spaces
  • Thrift stores
  • Yard sales
  • Hardware stores
  • Fabric stores
  • Local dairy suppliers
  • Grocery stores
  • Your own recycling bin

Here is a loose parts list that will inspire you to get out there and collect your own:

Illustration 3 code:

What Are Loose Parts - Bring Back Children’s Play
Source: Blog

To support children in loving play again, it is important that we create environments and include materials that are fun, engaging, and challenging. If an environment or an object is too easy, children will view it as boring. To reintroduce adventure and free play to your children, consider using loose parts. When loose parts are paired with the outdoors, it will lift children’s spirits, make them love playing again, and ultimately make them happier and healthier.